title: Childbirth and female sexual function later in life.
abstract: OBJECTIVE
  To examine relationships among parity, mode of delivery, and other parturition-related factors with women's sexual function later in life.
  
  
  METHODS
  Self-administered questionnaires examined sexual desire, activity, satisfaction, and problems in a multiethnic cohort of women aged 40 years and older with at least one past childbirth event. Trained abstractors obtained information on parity, mode of delivery, and other parturition-related factors from archived records. Multivariable regression models examined associations with sexual function controlling for age, race or ethnicity, partner status, diabetes, and general health.
  
  
  RESULTS
  Among 1,094 participants, mean (standard deviation) age was 56.3 (±8.7) years, 568 (43%) were racial or ethnic minorities (214 African American, 171 Asian, and 183 Latina), and 963 (88%) were multiparous. Fifty-six percent (n=601) reported low sexual desire; 53% (n=577) reported less than monthly sexual activity, and 43% (n=399) reported low overall sexual satisfaction. Greater parity was not associated with increased risk of reporting low sexual desire (adjusted odds ratio [OR] 1.08, confidence interval [CI] 0.96-1.21 per each birth), less than monthly sexual activity (adjusted OR 1.05, CI 0.93-1.20 per each birth), or low sexual satisfaction (adjusted OR 0.96, CI 0.85-1.09 per each birth). Compared with vaginal delivery alone, women with a history of cesarean delivery were not significantly more likely to report low desire (adjusted OR 0.71, CI 0.34-1.47), less than monthly sexual activity (adjusted OR 1.03, CI 0.46-2.32), or low sexual satisfaction (adjusted OR 0.57, CI 0.26-1.22). Women with a history of operative-assisted delivery were more likely to report low desire (adjusted OR 1.38, CI 1.04-1.83).
  
  
  CONCLUSIONS
  Among women with at least one childbirth event, parity and mode of delivery are not major determinants of sexual desire, activity, or satisfaction later in life.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics & Gynecology, University of Chicago, Chicago, Illinois; the Departments of Obstetrics, Gynecology, & Reproductive Sciences, Family & Community Medicine, and Medicine, University of California, San Francisco, San Francisco, California; and the Division of Research, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Fehniger
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Creasman
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: David H
authors.initials: DH
authors.lastname: Thom
authors.forename: Leslee L
authors.initials: LL
authors.lastname: Subak
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D001213:Asian; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010298:Parity; D010549:Personal Satisfaction; D012725:Sexual Behavior / Q000208:ethnology / Q000502:physiology*; D012747:Sexual Partners; D011795:Surveys and Questionnaires